1. Field of the Invention
The invention relates to an adapter for subsequent shortening of a PEG probe which has already been put in place for artificial feeding.
2. Description of the Related Art
A PEG probe is fitted by introducing an endoscope or gastroscope into the patient's stomach and opening the stomach out by insufflation of air. A cannula is then advanced through the abdominal wall and stomach wall into the stomach lumen. A guide wire is introduced through the cannula into the stomach lumen, it is gripped with the endoscope or gastroscope and pulled back out through the patient's esophagus and mouth. With the aid of the guide wire which has been fitted in this way, the probe is then guided to the interior of the stomach and from there outward via the cannula. This procedure is also referred to as percutaneaus endoscopic gastrostomy (PEG).
At their distal end, the known PEG probes generally used have an inner retaining member with which the probe tube bears on the inner wall of the stomach. The probe tube is dimensioned so that it extends far out from the abdominal wall. At its proximal end the tube has a connection part in order to be able to connect the system far delivering nutrient solution. To close the probe tube, a conventional tube clamp or integrated closure cap is also often provided.
The known PEG probes have proven themselves in practice. However, a problem experienced by active patients is the fact that the probe tube protrudes relatively far out.
U.S. Pat. No. 5,549,657 describes a PEG probe which has an adapter for connection of a delivery system. The adapter is pushed on to the tube of the PEG probe and locked in place by means of a clamp. A disadvantage is that the probe tube has to be cut off immediately above the abdominal wall and has to be shortened exactly to the correct length. If the probe tube is cut too short, the adapter can no longer be secured, meaning that a new PEG probe has to be fitted. By contrast, if the probe tube is too long, the adapter does not lie on the abdominal wall. Furthermore, securing the adapter on the probe tube cut off just a short distance above the abdominal wall is relatively difficult.
The adapter is closed off by a slotted valve which opens upon connection of the delivery system. To open the valve, the connection part of the delivery system has a protruding cannula which is inserted into the adapter. For this reason, the known PEG probe is not directly compatible with the conventional delivery systems which have a Luer lock connector. In addition, there is a risk that the Y-shaped slotted valve does not provide a complete seal and too quickly loses its ability to function.
DE 197 49 741 C1 describes a fixing device for securing a PEG probe which has a support plate. The support plate has a recess for passage of the probe and a clamp part. To clamp the probe with the clamp part, the probe tube is bent through 90° above the abdominal wall. The known fixing device does not have means for connection of the probe tube of the PEG probe or a delivery tube of a delivery system.
WO 00/48658 describes a PEG probe with an inner retaining member located at its distal end and bearing on the stomach wall, and with a connection piece at its proximal end. To fix the probe on the abdominal wall of the patient, an outer retaining member is provided which has an opening for passage of the probe tube. The probe tube extends through the outer retaining member. The probe tube protrudes relatively far out from the abdominal wall, which is a disadvantage.
WO 99/25414, WO 99/55409 and U.S. Pat. No. 5,947,931 disclose securing systems for probe tubes on the patient's body. These securing systems, however, are not designed for shortening the probe tube of a PEG probe.